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chapter 44 - Chapter 44 Pituitary and Adrenal Disorders...

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Chapter 44: Pituitary and Adrenal Disorders MULTIPLE CHOICE 1. The patient with acromegaly asks the purpose of the glucose tolerance test (GTT). The nurse responds by saying that: 1. “The doctor wants to know if you have either diabetes or acromegaly.” 2. “The growth hormone will cause the glucose to be used up very quickly during the test.” 3. “It measures the growth hormone in the presence of oral glucose levels at specified times.” 4. “It tells whether your thyroid reacts to the high levels of sugar taken during this test.” ANS: 3 The level of growth hormone will drop in the presence of oral glucose. In the patient with acromegaly, the growth hormone level stays the same. The GTT is the best diagnostic tool for acromegaly. PTS: 1 DIF: Cognitive Level: Analysis REF: 953, Diagnostic Tests and Procedures table, 954 OBJ: 2 TOP: Acromegaly KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2. The preoperative teaching for a patient scheduled for a transsphenoidal hypophysectomy should include the instruction that postoperatively, the patient should: 1. avoid sneezing. 2. drink through a straw. 3. cough forcefully. 4. wash mouth out with peroxide. ANS: 1 The patient should be taught to avoid sneezing, coughing, drinking through a straw, or using a stringent mouthwash that might dislodge the graft. PTS: 1 DIF: Cognitive Level: Application REF: 959 OBJ: 4 TOP: Pituitary Surgery KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 3. The nurse is aware that the large flattened features of the patient with acromegaly are caused by an excess of: 1. prolactin. 2. growth hormone. 3. thyroid-stimulating hormone. 4. adrenocorticotropic hormone. ANS: 2
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Excess growth hormone in an adult will cause the flat bones to grow, because the adult has little capacity for heightened growth. In a child, this same excess would cause giantism. PTS: 1 DIF: Cognitive Level: Knowledge REF: 952 OBJ: 3 TOP: Acromegaly KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 4. On an intake physical, the nurse questions the patient with diabetes insipidus (DI) about the classic symptoms of that disease, which are: 1. dizziness, tachycardia, and weakness. 2. massive diuresis, hypertension, and excitability. 3. stress incontinence, vomiting, and edema. 4. bradycardia, insomnia, and muscle cramps. ANS: 1 The hypovolemia associated with DI dehydration leads to decreased intravascular volume. PTS: 1 DIF: Cognitive Level: Application REF: 961 OBJ: 1 TOP: Diabetes Insipidus KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 5. The nurse explains to the patient admitted for the evaluation of SIADH (syndrome of inap- propriate antidiuretic hormone) that the medical treatment plan would include: 1. strict enforcement of fluid restriction.
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